Risk Factors for Muscle Loss in Hemodialysis Patients with High Comorbidity

Visser, Wesley J.; Egmond, Anneke M E de Mik-van; Timman, Reinier; Severs, David; Hoorn, Ewout J.

doi:10.3390/nu12092494

Cited by 17 publications

(10 citation statements)

References 48 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, the difference did not achieve statistical significance, most likely due to the small sample size. DM as a covariate in the multivariate model was also not associated with greater LTM loss over time [31]. We intend to verify the observations of Marcelli et al and Visser et al with serial BIA assessments during the follow-up of our studied group.…”

Section: Discussionsupporting

confidence: 63%

Can Overnutrition Lead to Wasting?—The Paradox of Diabetes Mellitus in End-Stage Renal Disease Treated with Maintenance Hemodialysis

et al. 2022

View full text Add to dashboard Cite

Background: The population of end-stage renal disease (ESRD) patients with diabetes mellitus (DM) may be at increased risk of protein energy wasting (PEW). The aim of the study was to investigate the impact of DM on selected indicators of PEW in the ESRD population that was undergoing maintenance hemodialysis (MHD). Methods: A total of 515 MHD patients were divided into two subgroups with and without DM. The evaluation of diet composition, Charlson Comorbidity Index (CCI), SGA, and laboratory and BIS analyses were performed. All-cause and cardiovascular mortality was recorded. Results: DM patients had lower albumin (3.93 (3.61–4.20) vs. 4.10 (3.80–4.30) g/dL, p < 0.01), total cholesterol (158 (133–196) vs. 180 (148–206) mg/dL, p < 0.01), and creatinine (6.34 (5.08–7.33) vs. 7.12 (5.70–8.51) mg/dL, p < 0.05). SGA score (12.0 (10.0–15.0) vs. 11.0 (9.0–13.0) points, p < 0.001), BMI (27.9 (24.4–31.8) vs. 25.6 (22.9–28.8) kg/m2, p < 0.001), fat tissue index (15.0 (11.4–19.6) vs. 12.8 (9.6–16.0) %, p < 0.001), and overhydration (2.1 (1.2–4.1) vs. 1.8 (0.7, 2.7) L, p < 0.001) were higher in the DM group. Increased morbidity, reflected in the CCI and mortality—both all-cause and cardiovascular—were observed in DM patients. Conclusions: Hemodialysis recipients with DM experience overnutrition with a paradoxically higher predisposition to PEW, expressed by a higher SGA score and lower serum markers of nutrition. This population is also more comorbid and is at higher risk of death, including from cardiovascular causes.

show abstract

Section: Discussionsupporting

confidence: 63%

Can Overnutrition Lead to Wasting?—The Paradox of Diabetes Mellitus in End-Stage Renal Disease Treated with Maintenance Hemodialysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Chronic kidney disease is one of the most important etiologies of secondary sarcopenia, especially when HD is required. Although some studies have shown that lean body mass loss was not marked in patients undergoing HD 17 – 19 , a previous report showed that patients receiving HD who could not receive kidney transplantation due to comorbidities had a decrease in lean body mass by 17.1% in 20 weeks 20 . In this study, the participants receiving HD had a mean age of approximately 70 years, and their median annual %PMI was −9.5%.…”

Section: Discussionmentioning

confidence: 92%

The impact of muscle mass loss and deteriorating physical function on prognosis in patients receiving hemodialysis

Kitamura

Takazono

Yamaguchi

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Muscle mass loss and worsening physical function are crucial issues in patients receiving hemodialysis (HD). However, few studies have investigated the association between temporal changes in muscle mass and physical function in a large number of HD patients. We examined 286 patients receiving HD (males, 58%; age, 66.8 ± 13.0 years) at a single center, and calculated the percent changes in psoas muscle mass index (%PMI) using computed tomography over two screenings, once per year (July 2011–June 2013). Physical function was evaluated using the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) (range 0–4). The observation period was from July 2012 to June 2021. The median %PMI was -9.5%, and those with the lowest quartile of %PMI (< −20.5%) showed a significantly poor prognosis compared with other patients (p < 0.001). Multivariable logistic regression analysis revealed that these patients tended to have decreased physical function (ECOG-PS 2–4) [odds ratio (OR): 2.46, p < 0.001] and albumin levels (OR: 0.22, p = 0.007). Multiple-factor-adjusted Cox regression analyses showed that %PMI (hazard ratio: 0.99, p = 0.004) and each ECOG-PS stage (1–4 vs. 0) (p < 0.01) were associated with mortality. Augmenting physical activities in daily life and serum albumin levels should be considered to maintain muscle mass and improve the prognosis of patients receiving HD.

show abstract

“…However, studies have demonstrated the safety and feasibility of promoting rehabilitation and early mobilization in ICU with femoral dialysis catheter [40,41]. Patients undergoing renal replacement therapy often experience loss of muscle mass secondary to progression of kidney disease, a decrease in protein synthesis, an increase in proteolysis, acidosis, inflammation, and the use of corticosteroids, which contributes to a catabolic state [42,43].…”

Section: Plos Onementioning

confidence: 99%

The Perme Mobility Index: A new concept to assess mobility level in patients with coronavirus (COVID-19) infection

et al. 2021

View full text Add to dashboard Cite

Introduction The Coronavirus Disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. Data on the mobility level of patients with COVID-19 in the intensive care unit (ICU) are needed. Objective To describe the mobility level of patients with COVID-19 admitted to the ICU and to address factors associated with mobility level at the time of ICU discharge. Methods Single center, retrospective cohort study. Consecutive patients admitted to the ICU with confirmed COVID-19 infection were analyzed. The mobility status was assessed by the Perme Score at admission and discharge from ICU with higher scores indicating higher mobility level. The Perme Mobility Index (PMI) was calculated [PMI = ΔPerme Score (ICU discharge–ICU admission)/ICU length of stay]. Based on the PMI, patients were divided into two groups: “Improved” (PMI > 0) and “Not improved” (PMI ≤ 0). Results A total of 136 patients were included in this analysis. The hospital mortality rate was 16.2%. The Perme Score improved significantly when comparing ICU discharge with ICU admission [20.0 (7–28) points versus 7.0 (0–16) points; P < 0.001]. A total of 88 patients (64.7%) improved their mobility level during ICU stay, and the median PMI of these patients was 1.5 (0.6–3.4). Patients in the improved group had a lower duration of mechanical ventilation [10 (5–14) days versus 15 (8–24) days; P = 0.021], lower hospital length of stay [25 (12–37) days versus 30 (11–48) days; P < 0.001], and lower ICU and hospital mortality rate. Independent predictors for mobility level were lower age, lower Charlson Comorbidity Index, and not having received renal replacement therapy. Conclusion Patients’ mobility level was low at ICU admission; however, most patients improved their mobility level during ICU stay. Risk factors associated with the mobility level were age, comorbidities, and use of renal replacement therapy.

show abstract

Risk Factors for Muscle Loss in Hemodialysis Patients with High Comorbidity

Cited by 17 publications

References 48 publications

Can Overnutrition Lead to Wasting?—The Paradox of Diabetes Mellitus in End-Stage Renal Disease Treated with Maintenance Hemodialysis

Can Overnutrition Lead to Wasting?—The Paradox of Diabetes Mellitus in End-Stage Renal Disease Treated with Maintenance Hemodialysis

The impact of muscle mass loss and deteriorating physical function on prognosis in patients receiving hemodialysis

The Perme Mobility Index: A new concept to assess mobility level in patients with coronavirus (COVID-19) infection

Contact Info

Product

Resources

About